Lack of contraception costs over 100,000 lives a year - expert

LONDON (TrustLaw) – More than 100,000 women die needlessly every year because they do not have access to contraception, experts said ahead of a major summit on family planning - a neglected issue they called the “Cinderella” of global health.

A new study, published by the Lancet medical journal, suggests improving access to contraception could reduce maternal deaths from pregnancy complications and botched abortions by around 30 percent.

Delaying child-bearing and spacing out births would also significantly cut infant and child mortality, increase parents’ ability to educate their children and reduce poverty, scientists said.

Smaller, better educated populations would in turn boost economic development and bring environmental benefits by easing pressure on resources and cutting CO2 emissions.

“About 100,000 women a year die unnecessarily from pregnancies that they didn’t want to have. And that is a scandal,” said Professor John Cleland, an expert in medical demography at the London School of Hygiene and Tropical Medicine.

Early pregnancies before the pelvis is fully developed, late pregnancies after the age of 40 and multiple, closely spaced births all increase the risk of maternal death. Tens of thousands of women also die from unsafe abortions every year.

In addition, back to back pregnancies increase the risk of premature births and deaths in newborns and young children, Cleland said.

He was speaking ahead of the London Summit on Family Planning on Wednesday, which will launch an initiative to give 120 million more women access to voluntary family planning methods by 2020.

Across the developing world more than 200 million women want modern contraception, but cannot get it.

Around 300,000 women and 3 million newborn babies are thought to die of complications relating to pregnancy and childbirth every year.

Dr Saifuddin Ahmed of the Bloomberg School of Public Health in the United States, who carried out the study into the potential effects of contraceptive use on maternal mortality, said improved access to family planning could save the lives of 104,000 girls and women globally, including around 59,000 in sub-Saharan Africa and 32,000 in South Asia.

The study is part of a special report on family planning by the Lancet which will underpin the international summit.

WIN-WIN SOLUTION

Dr Alex Ezeh of the African Population and Health Research Centre in Kenya said voluntary family planning programmes could reduce fertility by about 1.5 births per woman.

He told TrustLaw that Kenya, Rwanda and Ethiopia were all investing in improving family planning.

Countries lagging behind include Somalia, Democratic Republic of Congo and Chad, Ezeh said. He also pointed to Niger, whose population is predicted to more than triple between 2010 and 2050.

“Family planning programmes provide a win-win solution; the welfare of individual women and children is improved, and the national economy and environment benefit,” Ezeh added.

Dr Richard Horton, the Lancet’s editor, said there was an “extraordinary degree of consensus” across the scientific, advocacy and political communities ahead of the summit, which is hosted by the British government and the Bill and Melinda Gates Foundation.

“We’re on the cusp of what is a new social movement for family planning,” he added.

“Family planning for the last decade or so has been so neglected, so marginalised in global health, it has been the Cinderella of global health, and this is an opportunity to correct the mistakes of the past …”

Scientists said the biggest hurdles between women and access to contraception include lack of information, fears about side-effects and opposition from partners.

But they said religious opposition is not the major obstacle that many people believe it to be, as long as the government is on board.

Experts said improving family planning in developing countries would enhance economic development by boosting women’s ability to work, by increasing the ratio of working adults to dependents and by allowing greater investment in each child’s health and education.

Improving reproductive health will not only help poorer countries reach the internationally agreed Millennium Development Goals on reducing maternal and child mortality, but also other MDGs including eradicating poverty and hunger, achieving universal primary education and promoting gender equality, they added.

(Editing by Lisa Anderson)

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